ReviewWorld journal of emergency surgery : WJES2016
Laparoscopic lavage versus resection in perforated diverticulitis with purulent peritonitis: a meta-analysis of randomized controlled trials.
Review in World journal of emergency surgery : WJES, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04254224 (Scandinavian Diverticulitis Trial SCANDIV II), which is not on this map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Scandinavian Diverticulitis Trial SCANDIV II: Treatment of Acute Complicated Diverticulitis: a Prospective Observational Study
Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting.World journal of emergency surgery : WJES · 2020Guideline
- Perforated sigmoid diverticulitis: Hartmann's procedure or resection with primary anastomosis-a systematic review and meta-analysis of randomised control trials.Techniques in coloproctology · 2018Pooled it
- Laparoscopic Lavage in the Management of Perforated Diverticulitis: a Contemporary Meta-analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Pooled it
- Laparoscopic lavage versus surgical resection for acute diverticulitis with generalised peritonitis: a systematic review and meta-analysis.Techniques in coloproctology · 2017Pooled it
- Two-year results of the randomized clinical trial DILALA comparing laparoscopic lavage with resection as treatment for perforated diverticulitis.The British journal of surgery · 2018Trial
- Diverticulitis, surgery, evidence-based medicine, and the Steve Jobs' dots: a narrative review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Review
- Outcomes of surgical treatment of diverticular abscesses after failure of antibiotic therapy.Updates in surgery · 2023Article
- Current Aspects on the Management of Perforated Acute Diverticulitis: A Narrative Review.Cureus · 2022Review
- The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly.World journal of emergency surgery : WJES · 2022Review
- Complicated Diverticular Disease.Clinics in colon and rectal surgery · 2021Review
- Laparoscopic Lavage in the Management of Hinchey III/IV Diverticulitis.Clinics in colon and rectal surgery · 2021Review
- Drains, Germs, or Steel: Multidisciplinary Management of Acute Colonic Diverticulitis.Digestive diseases and sciences · 2020Review
- Ruptured liver abscess presenting as pneumoperitoneum caused by Klebsiella pneumoniae: a case report.BMC surgery · 2020Article
- The Bucharest ESTES consensus statement on peritonitis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Review
- Percutaneous drainage for hinchey Ib and II acute diverticulitis with abscess improves outcomes.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2019Article
- Perforated diverticulitis in the North of England: trends in patient outcomes, management approach and the influence of subspecialisation.Annals of the Royal College of Surgeons of England · 2019Article
- Long-term follow-up of a multicentre cohort study on laparoscopic peritoneal lavage for perforated diverticulitis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2019Article
- The Multidisciplinary Management of Acute Complicated Diverticulitis.Inflammatory intestinal diseases · 2018Review
- Perforated sigmoid diverticulitis: Hartmann's procedure or resection with primary anastomosis.Techniques in coloproctology · 2018Article
- Inflammation management in acute diverticulitis: current perspectives.Journal of inflammation research · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePurulent peritonitis from acute left colon diverticulitis is a relatively common presentation of diverticular disease; historically the treatment was the Hartmann procedure. Laparoscopic peritoneal lavage has been proposed as a lesser invasive treatment option with great interest and debate among surgeons and with contrasting results. The aim of this meta-analysis was to compare the results of sigmoid resection with laparoscopic lavage.
methodsA systematic review was performed to select randomized controlled trials comparing laparoscopic lavage versus resection in Hinchey III diverticulitis. Studies' selection, data extraction and risk of bias assessment were done by two independent authors; results were shown as OR with 95 % C.I.
resultsThree RCT were selected for the meta-analysis including 315 patents. Laparoscopic lavage was associated with significantly more reoperations (OR 3.75, p = 0.006) and more intra-abdominal abscesses (OR 3.50, p = 0.0003) with no differences in mortality (OR 0.93, p = 0.92). At 12 months follow up laparoscopic lavage was associated with lesser reoperations (OR 0.32, p = 0.0004); there were no differences in term of stoma presence (OR 0.44 p = 0.27) and mortality (OR 0.74 p = 0.51).
conclusionsThe present meta-analysis shows that in acute perforated diverticulitis with purulent peritonitis laparoscopic lavage is comparable to sigmoid resection in term of mortality but it is associated with a significantly higher rate of reoperations and a higher rate of intra-abdominal abscess. No differences in term of mortality were demonstrated at follow-up. Further studies are needed to better define the safety and appropriateness of this treatment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.